Germany vs the UK, USA and Gulf for nurses and doctors: pay, path and timeline

Choosing between Germany, the UK, USA and Gulf as a nurse or doctor? The best fit depends on your qualification, how soon you want to move and whether pay, permanent residence or training costs matter most to you.

First check the licence you need, the language you speak and how long you can wait before earning. Then compare job offers and long-term residence options.

Here we compare Germany, the UK, the USA and the UAE as a Gulf example. British pay figures cover England. Saudi Arabia and other Gulf countries have their own licensing and immigration rules, so the UAE details do not apply to them.

• Germany: Nurses: Your state's nursing office grants the Erlaubnis (permission to use the protected nurse title). EU qualifications may be recognised automatically. Other qualifications are checked one by one. Remaining gaps are closed with an adaptation period or a knowledge or aptitude test.; Doctors: The competent authority in the relevant German state grants the Approbation (full licence to work as a doctor). For new applications based on a medical qualification from a third country filed from 1 November 2026, the direct Kenntnisprüfung (knowledge exam) is the default. You can instead choose the document-based equivalence assessment within four weeks after applying. Applications filed by 31 October 2026 remain under the previous rules; EU, EEA and Swiss qualifications follow separate rules.
• UK: Nurses: NMC (the UK nursing regulator) "Test of Competence": a computer-based test (CBT), then a practical exam (OSCE). You must pass both within two years of each other.; Doctors: GMC (the UK medical regulator) registration for international graduates, usually through the PLAB exam or an accepted postgraduate qualification. Check the current route on gmc-uk.org.
• USA: Nurses: Each state's nursing board gives the licence. NCSBN writes and runs the NCLEX-RN exam that the boards require. A credential evaluator (e.g. CGFNS) checks your education. It does not license you.; Doctors: USMLE Step 1 and Step 2 CK, then ECFMG certification (this now includes an English test, OET Medicine). Then a residency place through the NRMP Match, before a full state licence. USMLE Step 3 is also required before unrestricted state licensure.
• UAE (Gulf): Nurses: For both professions, the emirate where you will work gives the licence. Dubai's DHA: an outside agency checks your documents with the places that issued them, then a computer-based test or oral assessment. Abu Dhabi's DOH: documents checked through Dataflow, then a Pearson VUE exam.; Doctors: Same two regulators as for nurses, by emirate: DHA (Dubai) or DOH (Abu Dhabi).

• Germany: general German at B2 for nurses. Doctors need B2 plus a medical German exam at C1, the Fachsprachprüfung.
• UK: if you prove English to the NMC through tests, you need IELTS Academic scores of Listening 7, Reading 7, Writing 6.5 and Speaking 7, or the accepted OET equivalents. For doctors, the GMC normally asks for IELTS Academic 7.5 overall with at least 7 in each component, or OET Medicine grade B in each component. Other proof may be accepted; check your regulator's rules.
• USA: the ECFMG Pathways for doctors use OET Medicine. As a nurse, check your state board and any healthcare-worker certification needed for immigration. Passing NCLEX alone does not settle every language or immigration requirement.
• UAE: DHA and DOH licensing runs in English. Neither page named an Arabic requirement.

Check the language evidence for your profession and registration route before paying for an exam.

Germany and England list base salary scales for specified roles; the USA lists occupation-wide medians across employers and experience levels. The US physician median is not a resident doctor's starting pay. These figures help you compare, but cannot tell you where you will earn most.

Over a year, Germany's P7 nursing scale comes to €42,123.60 to €51,664.80, and its grade I doctor scale to €68,664.60 to €88,263.48. That means twelve months at the May/June 2026 rates, without allowances or annual special payments. It does not show actual earnings for calendar year 2026, when rates changed.

For each offer, list annual base pay, contracted hours, paid on-call work, allowances, tax, insurance, rent and moving costs separately. If you convert currencies, show the exchange-rate date and the costs you assumed for each country.

• Nurse: Germany (public-sector pay tables TVöD and TV-Ärzte, gross per month, from May/June 2026): P7 (3+ years of training): €3,510.30-€4,305.40; England (base pay per year, 2026/27 where shown): NHS Band 5: £32,073-£39,043; USA (BLS occupation-wide median per year, May 2025; not starting pay): Registered nurses, median: $97,550; UAE (Gulf example): No official pay scale found
• Doctor: Germany (public-sector pay tables TVöD and TV-Ärzte, gross per month, from May/June 2026): Grade I (Assistenzarzt, doctor in specialist training): €5,722.05-€7,355.29; England (base pay per year, 2026/27 where shown): Resident doctor basic pay, 2026/27 deal: FY1 £41,226 to ST8 £77,348; consultant basic salary, 2003 contract from 1 April 2026: £113,565-£150,569; USA (BLS occupation-wide median per year, May 2025; not starting pay): Physicians and surgeons, median: $275,930; UAE (Gulf example): No official pay scale found

We have no representative UAE salary figure to compare. Ask for base pay, housing or housing allowance, insurance, hours, overtime and annual travel benefits in writing. One employer's package cannot tell you what others in the UAE or Saudi Arabia pay.

The nurse salary and doctor salary posts give full German pay tables and figures by state. If you work as an assistant, check nursing assistant salary in Germany.

Each country publishes pay in its own way, so compare the offer you actually get.

• Germany: Settlement / permanent residence: Skilled-worker route: 3 years (2 years if you trained in Germany), with German at B1. EU Blue Card: 27 months with German at A1, or 21 months at B1. The Blue Card needs a salary of €50,700 a year (2026), or €45,934.20 for some groups if the Federal Employment Agency agrees. These groups include doctors (ISCO 221) and nurses with a degree (ISCO 222). The Blue Card usually needs a recognised university degree. A narrower route without a degree exists for other groups (see Sources).; Citizenship: 5 years of legal residence. The old fast route after 3 years has been removed.
• UK: Settlement / permanent residence: Under the current rules, you can qualify for permanent residence after five years on the Health and Care Worker visa if you meet the requirements. The government response of 2 November 2026 (CP 1707) sets a ten-year standard, with faster and slower pathways. Eligible workers in specified health and education occupations paid on national scales, including doctors and nurses, can qualify after five years if they meet the other requirements; see Annex C. Implementation rules remain pending.; Citizenship: 5 years of residence plus 12 months with ILR.
• USA (nurses): Settlement / permanent residence: A US employer files an I-140 petition under EB-3 "Schedule A". Schedule A is approved in advance, so it skips the usual check of the job market. The nurse cannot file alone. Then the wait depends on the Visa Bulletin. The November 2026 EB-3 Final Action Dates are 15 June 2024 (most countries), 22 Jan 2014 (India) and 15 Aug 2023 (Philippines).; Citizenship: 5 years as a permanent resident.
• UAE (Gulf): Settlement / permanent residence: No Western-style permanent route for most employees. A normal visa is tied to your job and renewed every 2 years. The Golden Visa gives 10 years of residence that you can renew, without a sponsor, to named skilled groups, including doctors.; Citizenship: No path a worker can apply for. A narrow exception by nomination only (through the Rulers' or Crown Princes' Courts) names doctors as eligible. But you cannot apply yourself.

• Germany: a spouse and children under 18 can join a residence permit holder. Spouses usually must first show simple German (level A1). This test is dropped for spouses of Blue Card holders, skilled workers and some other permit holders (see Sources).
• UK: the Health and Care Worker visa lets a partner and children under 18 join. You must show money for their upkeep: £285 for a partner, £315 for the first child and £200 for each further child, held for 28 days. In some cases this is waived.
• UAE: to sponsor your family, you need a salary of AED 4,000 a month, or AED 3,000 plus housing.
• USA: green-card holders may apply for a spouse and unmarried children to immigrate too.

Family rules differ a lot between the four, so check them before you choose a country.

• You earn money during nursing Ausbildung, Germany's vocational training, without paying course fees.
• Recognition takes your existing qualification into account. If substantial differences remain, the office tells you which measures can make up for them. A knowledge exam can cover the German final-exam content; it is not necessarily limited to those gaps.
• With German at B1, the Blue Card route can lead to permanent residence in 21 months, among the fastest we reviewed. It applies to doctors and other staff with a qualifying degree.
• Without a job offer, qualified health workers can use the points-based Opportunity Card to look for work in Germany in person.

• You need your first nursing qualification: compare Germany's paid Ausbildung with the training costs elsewhere. If you already have a nursing qualification, check the nurse recognition requirements first.
• You want to nurse in the USA: check state licensing, employer sponsorship and the wait for your country of chargeability. Passing NCLEX does not guarantee an immigrant visa.
• You want the UK: check NMC or GMC registration, a sponsored offer and current residence rules separately.
• You have a UAE offer: compare the complete contract, the conditions for changing employer and family sponsorship.
• You qualify for Germany's EU Blue Card: consider its potentially shorter settlement wait. You must meet the qualification, job and salary conditions.

Language learning and paperwork do not start your settlement wait; you must meet the residence conditions first. Plan around your next unfinished step:

• Nurse starting German from scratch: plan time for language learning, training records, recognition, any adaptation measure, a job offer and the visa. Ask which steps can overlap.
• Nurse with B2 and German recognition already completed: focus on the employer, permission to work and the move. A programme estimate that includes a year of language learning will not fit your case.
• Doctor considering the USA: plan for certification, application deadlines and finding a residency place. Passing an exam guarantees neither a Match place nor a start date.
• Applicant considering the UK or UAE: check whether you qualify for registration and what the employer needs for sponsorship before booking travel. A job offer alone does not let you practise.

For each option, note the next exam or application date, cost, pending decision and backup plan for delays. Use your provider’s and regulator’s dates, rather than a promise of “six months to move”.

Find Germany's recognition steps in the nurses hub or doctors hub, and other roles in the professions overview. Our free personalised roadmap covers around 20 health professions, with steps for your country and German state.